Details

Autor(en) / Beteiligte

• Wedin, Madelene
• Stalberg, Karin
• Marcickiewicz, Janusz
• Ahlner, Eva
• Ottander, Ulrika
• Åkesson, Åsa
• Lindahl, Gabriel
• Wodlin, Ninnie Borendal
• Kjølhede, Preben
• Rundqvist, Eva
• Karlsson, Sarah
• Liest, Lisbeth
• Roos, Liselotte
• Andersson, Karin Norin
• Nyberg, Åsa
• Ervard, Karin
• Johansson, Helena
• Smith, Peter
• Henriksson, Anette
• Larsson, Lena
• Ehn, Ulrika
• Lood, Margareta
• Hermansson, Lena
• Satherberg, Eva
• Eliasson, Eva
• Blank, Eva
• Martinsson, Inga-Lill
• Westerling, Marie de-France
• Mattsson, Eva
• Rosén, Eva
• Bååthe, Birgitta
• Brodin, Elisabeth
• Möller, Matilda
• Hogström, Lars
• Buimer, Maarten
• Johansson, Agneta
• Andersson, Eva
• Tallbacka, Johanna
• Eriksson, Sofie
• Andrèen, Lotta
• Näslund, Christine
• Vidgren, Ylva
• Rosenberg, Per
• Shosholli, Linda
• Kersley, Åsa Rydmark
• Eklund, Jenny
• Sandström, Åsa
• Falk, Annika
• Stålberg, Karin Glimskär
• Eklind, Charlotte
• Strandh, Petra
• Ingvast, Nicola
• Andersson, Pia
• Källman, Lotti
• Grant-Pedersen, Viveka
• Rosenmüller, Anders
• Bergsten, Carina
• Dahlberg, Camilla
• Henning, Lars
• Engström, Andres Hess

Titel

Risk factors for lymphedema and method of assessment in endometrial cancer: a prospective longitudinal multicenter study

Ist Teil von

• International journal of gynecological cancer, 2021-11, Vol.31 (11), p.1416-1427

Ort / Verlag

England: BMJ Publishing Group Ltd

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• ObjectiveThe aim of the study was to determine risk factors for lymphedema of the lower limbs, assessed by four methods, 1 year after surgery for endometrial cancer.MethodsA prospective longitudinal multicenter study was conducted in 14 Swedish hospitals. 235 women with endometrial cancer were included; 116 underwent surgery including lymphadenectomy, and 119 had surgery without lymphadenectomy. Lymphedema was assessed preoperatively and 1 year postoperatively objectively by systematic circumferential measurements of the legs, enabling volume estimation addressed as (1) crude volume and (2) body mass index-standardized volume, or (3) clinical grading, and (4) subjectively by patient-reported perception of leg swelling. In volume estimation, lymphedema was defined as a volume increase ≥10%. Risk factors were analyzed using forward stepwise logistic regression models and presented as adjusted odds ratio (aOR) and 95% confidence interval (95% CI).ResultsRisk factors varied substantially, depending on the method of determining lymphedema. Lymphadenectomy was a risk factor for lymphedema when assessed by body mass index-standardized volume (aOR 14.42, 95% CI 3.49 to 59.62), clinical grading (aOR 2.11, 95% CI 1.04 to 4.29), and patient-perceived swelling (aOR 2.51, 95% CI 1.33 to 4.73), but not when evaluated by crude volume. Adjuvant radiotherapy was only a risk factor for lymphedema when assessed by body mass index-standardized volume (aOR 15.02, 95% CI 2.34 to 96.57). Aging was a risk factor for lymphedema when assessed by body mass index-standardized volume (aOR 1.07, 95% CI 1.00 to 1.15) and patient-perceived swelling (aOR 1.06, 95% CI 1.02 to 1.10), but not when assessed by crude volume or clinical grading. Increase in body mass index was a risk factor for lymphedema when estimated by crude volume (aOR 1.92, 95% CI 1.36 to 2.71) and patient-perceived swelling (aOR 1.36, 95% CI 1.11 to 1.66), but not by body mass index-standardized volume or clinical grading. The extent of lymphadenectomy was strongly predictive for the development of lymphedema when assessed by body mass index-standardized volume and patient-perceived swelling, but not by crude volume or clinical grading.ConclusionApparent risk factors for lymphedema differed considerably depending on the method used to determine lymphedema. This highlights the need for a ‘gold standard’ method when addressing lymphedema for determining risk factors.